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Exam 2.2

QuestionAnswer
What is placental abruption? The fetus detaches from uterine wall, eliminating perfusion. This is the leading cause of perinatal mortality.
What are causes of placental abruption? AMA or teen pregnancy, increased parity, smoking,alc,drugs, postamniocentesis, PPROM, previous abruption.
What is PPROM? Prolonged premature rupture of mmebrane.
Once placental abruption occurs, how long can you wait until you get the baby out? You have to get the baby out quick. couple minutes
Types of abruptio placentae Marginal abruption with external bleeding Partial abruption with concealed bleeding Complete abruption with concealed bleeding.
What is the outcome of abruptions? How are they graded? They all result in a C section. They are graded 1-3, mild to severe.
Which type of abruption can go unnoticed until delivery? Partial abruptions; Bleeding is trapped, so no signs and sx of abruption. Can go unnoticed until delivery.
Sx of abruption Sudden onset dark venous blood, severe and steady pain, uterus is tender with a firm and hard tone.
Tx of abruption Never put hands in a bleeding vag. Do FHR monitoring and call the doctor. US to verify dx then emergency c section within 30 minutes.
What is placenta previa? Placenta implants in lower segment of the uterus, covering the cervix.
What are the 4 types of placenta previa? Low lying, partial, marginal, and complete.
What is a possible complication of placenta previa? Can cause the placenta to come out first and the baby will have no O2.
What is the best type of placenta previa Low lying, since it can move back up, while the other 3 times do not move and result in C sections.
Placenta previa orders for activity, monitoring, and what you should have available Bedrest with bathroom privileges, no vag exams, monitor CBC and Rh factor, and 2 units cross matched blood available.
What are the sx of placenta previa Bright red bleeding if separation occurs, slow and quiet onset, pain only if in labor, and uterine tone is relaxed.
What is the tx of placenta previa? C section, nonemergent if no bleeding or immediate harm
What is placenta accreta? How is it treated? Chorionic villi attach directly to the myometrium causing maternal hemorrhage. It is treated by c section with possible hysterectomy.
How is placenta accreta identified? It has no sx, only identifiable via ultrasound.
Placenta increta grows through muscle to wall of uterus
Placenta percreta grows through muscle to the bladder, intestines, and other organs
placenta accreta grows through the myometrium
3+ c sections plus placenta previa puts you at a very high risk for what complication? Placenta accreta
 

 



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